Many countries are starting to roll out another booster of the COVID-19 vaccine but, with public interest waning and a sense of normalcy firmly installed in our minds, this may prove an ill-fated effort, unless authorities can provide a coherent answer to the question: “Is another jab really needed?”
The short answer, writes Dr Dr Salvador Macip in Medscape, is a firm “yes”, of course.
In what we could call the “chronic” phase of the pandemic, most countries have now settled for a certain number of daily cases and a (relatively low) number of complications and deaths. It’s the vaccines that have afforded us this peace of mind, lest we forget. But they are different from other vaccines with which we are more familiar, such as the MMR we get as kids and then forget about for the rest of our lives.
As good as the different COVID-19 vaccines are, they never came with the promise of generating lifelong antibodies. We knew early on that the immunity they provide slowly wanes with time.
That doesn’t mean that those who have their vaccination records up-to-date (which included a booster probably earlier this year) are suddenly exposed. Data suggest that although people several months past their last booster would now be more prone to getting reinfected, the protection against severe disease still hangs around 85%. In other words, their chances of ending up in the hospital are low.
Why worry, then, about further boosting the immune system? The same studies show that an additional jab would increase this percentage up to 99%. Is this ~10% improvement really worth another worldwide vaccination campaign? Well, this is a numbers game, after all. The current form of the virus is extremely infectious, and the northern hemisphere is heading toward the cold months of the year, which we have seen in past years increases COVID-19 contagions, as you would expect from any airborne virus.
Thus, it’s easy to expect a new peak in the number of cases, especially considering we are not going to apply any of the usual restrictions to prevent this. In these conditions, extending the safety net to a further 10% of the population would substantially reduce the total number of victims. It seems like a good investment of resources.
We can be more surgical about it and direct this new vaccination campaign to the population most likely to end up in the hospital. People with concomitant pathologies are at the top of the list, but it’s also an age issue. On the basis of different studies of the most common ages of admission, the cut-off point for the booster varies from country to country, with the lowest being 50 and in other cases hovering around 65 years of age. Given the safety of these vaccines, if we can afford it, the wider we cast the net, the better, but at least we should make every effort to fully vaccinate the higher age brackets.
The final question is which vaccine to give. There are confounding studies about the importance of switching to Omicron-specific jabs, which are finally available. Although this seems like a good idea, since Omicron infections elicit a more effective range of antibodies and new variants seem to better escape our defences, recent studies suggest that there actually may not be so much difference with the old formula.
The conclusion? Vaccinate the elderly (and some middle-aged too, if possible) and the frail as soon as possible with any version of the booster you have available, if you want to keep hospital pressure to the minimum and save a fair number of complications and deaths over the next months. This regimen of yearly boosters for some may be the scenario for the upcoming years, similar to what we already do for the flu, so we should get used to it.
• Dr Salvador Macip, PhD, a doctor, researcher and writer, obtained his MD/PhD at the University of Barcelona in 1998, then moved to do oncological research at the Mount Sinai Hospital (New York). Since 2008, he has led the Mechanisms of Ageing and Cancer Lab at the University of Leicester (UK).
Medscape article – Is Another COVID-19 Booster Really Needed? (Open access)
See more from MedicalBrief archives:
Why you’ll need COVID boosters repeatedly, like flu jabs – Yale experts
Second Pfizer booster only protects short-term against Omicron – Large Israeli study
Warning from WHO and EU regulator against repeat COVID boosters
UK vaccination committee says 4th booster not necessary